Nov 13 - 17, 2016


Dianna Hergott1 , Thomas Stabler2 , Jackie Cook2 , Guillermo Garcia3 , Aveika Akum3 , Immo Kleinschmidt2 , Christopher Schwabe1

1 Medical Care Development International, Silver Spring, MD, United States, 2 London School of Hygiene & Tropical Medicine, London, United Kingdom, 3 Medical Care Development International, Malabo, Equatorial Guinea

Between December 2014 and June 2015, the Bioko Island Malaria Control Project (BIMCP) distributed 149,287 long lasting insecticidal nets (LLIN) to 61,000 households on Bioko Island, achieving an Island-wide coverage of at least 1 LLIN per household of 87%. Of the 87% of households contacted who received a net, universal coverage (at least one net per two people) was achieved in 89% of them, for an Island-wise universal coverage of at least 77%. The BIMCP planned and implemented the distribution campaign through a tablet-based Campaign Information Management System (CIMS) that contains a georeferenced listing of all households on the Island, linked to a unique household identifier. Using the CIMS, data were collected on household size, number of pre-existing nets, and number of nets distributed. Between August and October of 2015, approximately 7 months after the mass distribution, the BIMCP carried out a Malaria Indicator Survey (MIS), taking a representative sample of all communities in the Island. The MIS included questions about bed-net ownership and usage. The MIS showed that net ownership had dropped by 22% between the time of distribution and the 2015 MIS, with 69% of households reporting owning at least one LLIN in the MIS. Universal coverage dropped by 45%, with only 42% of households reporting having at least one net per every two people. Using the geo-referenced unique household identifier, we were able to compare net ownership in 4,992 households. Fifty seven percent of these households reported having at least one less net at the time of the MIS than were distributed during the distribution campaign, and 34% reported at least two fewer nets. While many households reported a loss of nets, others reported a gain of nets. An in-depth analysis of the net code inscribed during the distribution and reported in the MIS, which reveal the original community LLINs were distributed to, will be conducted to investigate possible redistribution of nets. Additionally, results from the 2016 MIS will be analyzed to quantify net loss one year following the mass-distribution and better evaluate the characteristics of households with net gain and loss.